vitamin b12 + folic acid

Vitamin B12 and folic acid is an investigational combination therapy developed by the Washington University School of Medicine to mitigate the risk of perioperative cardiac events, specifically myocardial ischemia. This intervention was studied in the VINO (Vitamins in Nitrous Oxide) trial, targeting patients with MTHFR gene variants (C677T or A1298C) undergoing noncardiac surgery with nitrous oxide anesthesia. The biological rationale is that nitrous oxide causes an acute increase in plasma homocysteine by irreversibly inactivating vitamin B12, which serves as a cofactor for methionine synthase. This acute hyperhomocysteinemia is associated with an increased risk of perioperative myocardial infarction. The treatment involves intravenous administration of 1 mg vitamin B12 and 5 mg folic acid to maintain the methionine cycle and prevent homocysteine accumulation.

Other names

Vitamin B12 and folic acidVINO trial interventioncobalamin + folateVitamin B12 and folate